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<p>Oral Squamous Cell Carcinoma (OSCC) is considered a highly immunosuppressive malignancy largely mediated by the Programmed Cell Death 1/Programmed Cell Death Ligand 1(PD-1/PD-L1) axis. The interaction between PD-L1 expressed on tumor cells and PD-1 receptors on T-cells results in T-cell dysfunction, exhaustion, and immune evasion within the tumor microenvironment. This study aimed to evaluate PD-L1 expression in primary non-metastatic OSCC, primary metastatic OSCC, and nodal metastatic OSCC, as well as to investigate its association with different available clinicopathological parameters. Immunohistochemical staining was performed to retrospectively evaluate PD-L1 expression in 30 archival paraffin-embedded OSCC specimens retrieved from the Department of Oral Pathology, Faculty of Dentistry, and the Oncology Center, Faculty of Medicine, Mansoura University. PD-L1 immunoreactivity was evaluated using a semi-quantitative scoring system based on both the staining intensity and the percentage of positively stained cells. The percentage of immunopositive cells was scored as stated: 0 (0%); 1 (&lt; 25%); 2 (25–50%); 3 (50–75%); and 4 (&gt; 75%). Staining intensity was graded as follows: (0 = negative); (1 = weak); (2 = moderate); and (3 = strong). A combined immunoreactivity score was calculated by adding the percentage and the intensity for each case (range 0–7). The final score was categorized as follows: 0 (negative); 1–3 (weak); 4–7 (strong). Statistical analysis was conducted to determine significant differences and correlations between PD-L1 expression and clinicopathological parameters using the Chi-square test, Monte Carlo test, one-way ANOVA, Student’s t-test, and Fisher’s exact test. The p-value &lt; 0.05 was considered statistically significant. PD-L1 immunopositivity was detected in all OSCC cases (100%). A statistically significant difference was observed among the different studied groups (<i>p</i> &lt; 0.001), with the strongest PD-L1 expression detected in both primary metastatic and nodal metastatic OSCC. Strong PD-L1 expression showed a significant association with patient age (<i>p</i> = 0.024). Additionally, a significant correlation was identified between PD-L1 expression and the depth of tumor invasion (<i>p</i> &lt; 0.001). PD-L1 expression may have a potential role in tumor progression of OSCC.</p>

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Programmed cell death ligand 1(PD-L1) association in metastatic and non-metastatic oral squamous cell carcinoma: clinicopathologic and immunohistochemical study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月4日

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  • Eman M. Kamel,
  • Doaa A. M. Esmaeil,
  • Ramy A. Abdelsalam,
  • Azza A. El-Sisi

摘要

Oral Squamous Cell Carcinoma (OSCC) is considered a highly immunosuppressive malignancy largely mediated by the Programmed Cell Death 1/Programmed Cell Death Ligand 1(PD-1/PD-L1) axis. The interaction between PD-L1 expressed on tumor cells and PD-1 receptors on T-cells results in T-cell dysfunction, exhaustion, and immune evasion within the tumor microenvironment. This study aimed to evaluate PD-L1 expression in primary non-metastatic OSCC, primary metastatic OSCC, and nodal metastatic OSCC, as well as to investigate its association with different available clinicopathological parameters. Immunohistochemical staining was performed to retrospectively evaluate PD-L1 expression in 30 archival paraffin-embedded OSCC specimens retrieved from the Department of Oral Pathology, Faculty of Dentistry, and the Oncology Center, Faculty of Medicine, Mansoura University. PD-L1 immunoreactivity was evaluated using a semi-quantitative scoring system based on both the staining intensity and the percentage of positively stained cells. The percentage of immunopositive cells was scored as stated: 0 (0%); 1 (< 25%); 2 (25–50%); 3 (50–75%); and 4 (> 75%). Staining intensity was graded as follows: (0 = negative); (1 = weak); (2 = moderate); and (3 = strong). A combined immunoreactivity score was calculated by adding the percentage and the intensity for each case (range 0–7). The final score was categorized as follows: 0 (negative); 1–3 (weak); 4–7 (strong). Statistical analysis was conducted to determine significant differences and correlations between PD-L1 expression and clinicopathological parameters using the Chi-square test, Monte Carlo test, one-way ANOVA, Student’s t-test, and Fisher’s exact test. The p-value < 0.05 was considered statistically significant. PD-L1 immunopositivity was detected in all OSCC cases (100%). A statistically significant difference was observed among the different studied groups (p < 0.001), with the strongest PD-L1 expression detected in both primary metastatic and nodal metastatic OSCC. Strong PD-L1 expression showed a significant association with patient age (p = 0.024). Additionally, a significant correlation was identified between PD-L1 expression and the depth of tumor invasion (p < 0.001). PD-L1 expression may have a potential role in tumor progression of OSCC.